SC reprimands Doctors for Bad attitude towards poor patient, Enhances Compensation by Rs 10 lakh

"We are impelled to make these observations in the context of an uncomfortable fact indicated on the record that when the appellant was writhing in pain, she was not immediately attended at and was snubbed with the retort that ‘the people from hilly areas make unnecessary noise’. Such remarks, obviously, added insult to the injury and were least expected of the professionals on public duties."

New Delhi: The Supreme Court has recently asked Ripon DDU Hospital, Shimla to pay compensation of additional Rs 10 lakh compensation to a poor patient on account of amputation of right arm due to medical negligence.

The National Consumer forum earlier directed the hospital to pay compensation of Rs 2 lakh and besides this same, the patient was also allotted Rs 2,93,526 as an ex gratia amount from the hospital.

The court however while enhancing the compensation reprimanded the doctors for their attitude towards poor patients and iterated all the human beings deserve to be treated with equal respect and sensitivity.

The case concerns the complainant, Shoda Devi, 45, who was admitted to Deen Dayal Upadhyay (DDU)/Ripon Hospital - a government hospital at Shimla on 10.07.2006 after suffering from abdomen pain and menstrual problems. She was examined in the Ripon hospital on the next day and diagnosed with having fibroid and endometrial hyperplasia. She was first given medication and then advised to undergo a minor operation viz., Fractional Curettage (D & C).

On 19.07.2006, a para-medico had administered an intravenous injection of Phenergan and Fortwin directly in the right arm of the patient.

The patient continuously suffered excruciating pain during the entire surgical procedure and after the procedure, no measures were taken to redress and reduce the discomfort suffered by her.

Due to the complications that had arisen in regard to the arm of the patient, which could not be handled by the team of doctors at DDU Hospital, she was shifted to Indira Gandhi Medical College and Hospital, Shimla (IGMCH). In IGMCH, she was administered Brachial Plexus Block treatment immediately and, on being examined by CW-2, she was diagnosed with “acute arterial occlusion with ischemia of limb, caused by intra-arterial injection”, which ultimately resulted in CW-1 amputating her right arm above the elbow on 22.07.2006.

Alleging medical negligence, the patient filed an FIR against the doctors and hospital.

The matter when brought to the state commission, the hospital and doctors denied any negligence stating that they had provided services with utmost caution and care

IGMCH doctors appeared as witness and submitted that when she had arrived at the hospital in emergency with a history of severe pain in the right for arm and she was diagnosed with acute limb ischemia and treatment was given on these lines; but with the onset of gangrene, the right arm was amputated under his supervision to save the life  the patient.

The doctors further stated that the reaction to an injection administered could take place irrespective of the route of administration; that severity of limb ischemia is more if the whole drug is given intra arterially and occurs one in a million; and that preventive efforts should have been taken when the complaint of pain was made at the first instance. The doctors further stated that the treatment administered at DDU hospital was the one accepted as an initial line of treatment for management of pain in similar situations.

It was pointed out that the medical board had assessed her permanent disablement at 80%.

Holding no medical negligence, the state commission rejected the complaint. However  in view of the order previously passed on 16.09.2008 and response thereto by the Government, the State Commission directed the DDU to make ex gratia payment to the tune of Rs. 2,93,526/- to the appellant.

The appellant then moved to the National Commission with the evidence on record and particularly, the evidence of the cause of onset of gangrene on the appellant’s right arm as also the preventive measures which could have been, but were not, taken by the respondents. While holding it to be a clear case of medical negligence, the National Commission allowed the appeal but enhanced the compensation only to the tune of Rs. 2 lakh. The petitoner then moved the Supreme court

According to the counsel of the complainant, the amount was not justifiable to the loss she faced because of the negligence. The SC went through the literature of the case.

The SC in the judgment stated:

On the facts that have come on record, it appears that the appellant was 45 years of age when she suffered the medical negligence and consequences thereof, leading to amputation of her right arm. It is also apparent that the appellant comes from a very poor and rural background and is covered under Integrated Rural Development Programme. The National Commission, even after finding this one to be a case of medical negligence leading to amputation of right arm, quantified the amount of compensation only at Rs. 2,00,000/-. Even if the ex gratia proposed before the State Commission and the amount awarded by the National Commission are taken together, the total compensation to the appellant comes to Rs. 4,93,526/- only.

The judgment further stated:

We are constrained to observe that the National Commission, even after appreciating the troubles and trauma as also disablement and disadvantage suffered by the appellant, had been too restrictive in award of compensation. Ordinarily, the general damages towards pain and suffering as also loss of amenities of life deserve to be considered uniformly for the human beings and the award of compensation cannot go restrictive when the victim is coming from a poor and rural background; rather, in a given case like that of the appellant, such a background of the victim may guide the adjudicatory process towards reasonably higher amount of compensation (of course, after having regard to all the attending circumstances).

The Court further took a dig on the behaviour of the medical professionals towards the lady, the SC stated:

Such granting of reasonability higher amount of compensation in the present case appears necessary to serve dual purposes: one, to provide some succour and support to the appellant against the hardship and disadvantage due to amputation of right arm; and second, to send the message to the professionals that their responsiveness and diligence has to be equi-balanced for all their consumers and all the human beings deserve to be treated with equal respect and sensitivity.

We are impelled to make these observations in the context of an uncomfortable fact indicated on record that when the appellant was writhing in pain, she was not immediately attended at and was snubbed with the retort that ‘the people from hilly areas make unnecessary noise’. Such remarks, obviously, added insult to the injury and were least expected of the professionals on public duties.

The Court further added

 Apart from the above, when the appellant is shown to be a poor lady from rural background, her contribution in ensuring the family meeting both ends also deserves due consideration. With her disablement and reduced contribution, the amount of compensation ought to be of such level as to provide relief in reasonable monetary terms to the appellant and to her family.

After discussing and observing the case the SC issue an order where it directed the Hospital to pay compensation of Rs 10 lakh, over and above the amount awarded by the State Commission and the National Commission. Having regard to the quantum of enhancement being allowed herein, it is also considered proper to grant 3 months’ time to the respondents to make the requisite payment and else, to bear the burden of interest.